Nasogastric tube securement systems and methods of using same

ABSTRACT

A nasogastric tube securement system. The system can include a base layer and a coupling layer. The base layer can be configured to be adhered to a nose, the base layer having a first major surface comprising a skin-contact adhesive and a second major surface opposite the first major surface. The coupling layer can include a first end comprising coupling means configured to be repositionably coupled to the second major surface of the base layer, and a leg. The leg can be connected to and extending from the first end, can be elongated along a longitudinal direction, and can be configured to secure a nasogastric tube.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a national stage filing under 35 U.S.C. 371 ofPCT/US2016/047491, filed Aug. 18, 2016, which claims the benefit of U.S.Provisional Application No. 62/208,058, filed Aug. 21, 2015, thedisclosure of which is incorporated by reference in its entirety herein.

FIELD

The present disclosure generally relates to nasogastric tube securementsystems, and methods of using same, and particularly to systemsconfigured to be secured to skin.

BACKGROUND

During patient treatment (e.g., at hospitals, and particularly, inIntensive Care Units (ICUs)), the insertion of tubes can be required fordifferent purposes, such as feeding, air supply, and/or liquid removal.The tubes inserted through the nose are referred to as nasogastric (NG)tubes and can be used for various applications, including feeding, drugadministration and/or stomach drainage. Such nasogastric tubes generallyneed to be attached to the patient's skin in order to maintain thecorrect position internally, such as inside the stomach.

Some existing devices for NG tube securement do not allow a medicalpractitioner (e.g., a nurse) to intervene or evaluate the position orlevel of securement without removing an adhesive tape from skin, whichcan cause damage to the patient's skin (such as skin tears, redness,and/or damages due to constant changing of adhesives). Other existingdevices are large and bulky (e.g., configured to be attached around thepatient's head), thereby being cumbersome to use, reducing patientcomfort, and/or causing pressure ulcers.

SUMMARY

As a result, there is a need for robust, reliable, manipulatable,repositionable nasogastric tube securement systems, which provide for astandardization of procedures. The nasogastric tube securement systemsof the present disclosure can increase the safety of NG tube securementand patient's comfort, while minimizing skin damage. Systems of thepresent disclosure generally allow for repositioning of the NG tubeand/or the system (or a portion thereof) relative to a patient (e.g.,the patient's skin, the nose, and/or an internal structure) when needed.In general, systems of the present disclosure include a base layer forsecuring the system to a patient's nose, and a coupling layer configuredto be repositionably coupled to the base layer, while also beingconfigured to secure the NG tube. The coupling layer can be repositionedwithout removing the base layer from the skin or even changing the baselayer (e.g., comprising an adhesive tape) on the skin. In view of that,the comfort is enhanced and any potential risk for skin damage can beminimized.

The nasogastric tube securement systems of the present disclosure canalso reduce pressure ulcers in the nostril caused by the NG tubes, whichcan be a frequent problem on patients using NG tubes. The majority oftubes are secured by tapes or adhesive devices that are usually changedafter 24 hours which may increase the potential risk of pressure ulcersdeveloping in the nostril. However, by using the nasogastric tubesecurement systems of the present disclosure, the medical practitionercan evaluate a potential pressure point inside the nostril and takeaction to avoid the ulcers by changing the securement device positionwithout causing an adhesion lesion or reducing the securement of the NGtube.

Some aspects of the present disclosure provide a nasogastric tubesecurement system. The system can include a base layer and a couplinglayer. The base layer can be configured to be adhered to a nose, thebase layer having a first major surface comprising a skin-contactadhesive and a second major surface opposite the first major surface.The coupling layer can include a first end comprising coupling meansconfigured to be repositionably coupled to the second major surface ofthe base layer, and a leg. The leg can be connected to and extendingfrom the first end, can be elongated along a longitudinal direction, andcan be configured to secure a nasogastric tube. The leg can connect tothe first end at a position that is located toward a lateral side of thefirst end, relative to a lateral center of the first end, and the firstend can be wider than the leg in a lateral direction that is orientedsubstantially perpendicularly with respect to the longitudinaldirection.

Other features and aspects of the present disclosure will becomeapparent by consideration of the detailed description and accompanyingdrawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a plan view of a nasogastric tube securement system accordingto one embodiment of the present disclosure, the system shown in theform of a kit, the system comprising a base layer and a coupling layer.

FIG. 2A is a side cross-sectional view of the base layer of the systemof FIG. 1 according to one embodiment of the present disclosure, takenalong line 2A-2A of FIG. 1.

FIG. 2B is a side cross-sectional view of the coupling layer of thesystem of FIG. 1 according to one embodiment of the present disclosure,taken along line 2B-2B of FIG. 1.

FIG. 3A is a side cross-sectional view of the base layer of the systemof FIG. 1 according to another embodiment of the present disclosure.

FIG. 3B is a side cross-sectional view of the coupling layer of thesystem of FIG. 1 according to another embodiment of the presentdisclosure.

FIGS. 4A-4J illustrate a method of using the nasogastric tube securementsystem of FIG. 1.

FIGS. 5A and 5B each illustrate a base layer according to anotherembodiment of the present disclosure.

FIGS. 6A-6C each illustrate a coupling layer according to anotherembodiment of the present disclosure.

FIGS. 7A-7C each illustrate a coupling layer according to anotherembodiment of the present disclosure.

DETAILED DESCRIPTION

The present disclosure generally relates to nasogastric tube securementsystems and methods of using same. Particularly, nasogastric tubesecurement systems of the present disclosure include at least two partsor components: (i) a base layer that can be coupled (i.e., adhered) toskin, and (ii) a coupling layer having a portion configured to securethe nasogastric tube and a portion configured to be repositionablycoupled to the base layer to allow the nasogastric tube to berepositioned as desired without disrupting the base layer adhesion toskin, or requiring any portion of the base layer to be removed. The baselayer can remain in position on the skin until it becomes necessary tochange it or until the nasogastric tube is removed from the patient.

The systems of the present disclosure can be provided together as a kit,e.g., on one release liner, which can enhance manufacturability,packaging, ease-of-use and standardization of application procedures ortechniques.

As a result, the systems of the present disclosure provide arepositionable coupling layer that can be repositioned as desired on abase layer that remains stably adhered to the skin until the entiresystem is to be changed or removed. The repositionable coupling layersecures the nasogastric tube on the patient's nose in order to keep itwell placed. This allows site evaluation and helps reduce skin damage,as well as nostril pressure ulcers.

In some embodiments, the base layer can include a release agent (e.g., arelease coating) on its back side to which an adhesive on the couplinglayer can be adhered to ensure that the coupling layer (or at least aportion thereof) can be repositionable on the base layer. Alternativelyor additionally, in some embodiments, the base layer can include a firstmating surface of a mechanical fastener (e.g., hooks) on its back sideto which a second mating surface of the mechanical fastener on thecoupling layer (e.g., loops) can be repositionably engaged. This will bedescribed in greater detail below with reference to FIGS. 3A and 3B.

Definitions

The term “a”, “an”, and “the” are used interchangeably with “at leastone” to mean one or more of the elements being described.

The term “and/or” means either or both. For example “A and/or B” meansonly A, only B, or both A and B.

The terms “including,” “comprising,” or “having,” and variationsthereof, are meant to encompass the items listed thereafter andequivalents thereof as well as additional items.

Unless specified or limited otherwise, the terms “connected” and“coupled,” and variations thereof, are used broadly and encompass bothdirect and indirect connections and couplings.

The terms “layer,” “sheet,” and “dressing,” or variations thereof, areused to describe an article having a thickness that is small relative toits length and width.

The terms “polymer” and “polymeric material” refer to both materialsprepared from one monomer such as a homopolymer or to materials preparedfrom two or more monomers such as a copolymer, terpolymer, or the like.Likewise, the term “polymerize” refers to the process of making apolymeric material that can be a homopolymer, copolymer, terpolymer, orthe like. The terms “copolymer” and “copolymeric material” refer to apolymeric material prepared from at least two monomers.

The term “repositionable” refers to the ability of an article or surfaceto be, at least initially, repeatedly coupled to (e.g., adhered to) andremoved from a surface or substrate without substantial loss of couplingcapability (e.g., adhesion) and without damage to either surface (e.g.,article or underlying substrate) being coupled together. For example, acoupling layer of the present disclosure can be repositionable on a baselayer of the present disclosure if the base layer and the coupling layercan be removed, or decoupled, from one another without causing damage tothe base layer or the coupling layer. By way of example, somepressure-sensitive adhesives and mechanical fasteners arerepositionable.

The phrase “mechanical fastener” or “touch fastener” generally refers toa fastener that includes two mating, or engagement, surfaces configuredto be applied to one another, each mating surface having a plurality ofengagement structures or features, such that engagement structures onone mating surface are configured to engage with the engagementstructures on the opposing mating surface. In some embodiments, themechanical fastener can include two flexible mating strips or layers. Insome embodiments, the mechanical fastener can include a first matingsurface comprising tiny, stiff protrusions shaped like hooks that areconfigured to engage a second mating surface comprising pliable loops(i.e., a “hook and loop fastener,” or “hook and pile fastener”). In someembodiments, the mechanical fastener can include inter-engaging hooks(e.g., self-engaging hooks) on both mating surfaces (i.e., a “hook andhook fastener” or a “self-engaging hook fastener”).

“Peel force” refers to the force needed to “peel” one surface fromanother surface at an angle with respect to the plane between thesurfaces. Adhesive peel force can be measured using the ASTM methodreferenced in the “Adhesives” section below. Peel force between matingsurfaces of a mechanical fastener can be measured using ASTM D5170-98(2015)—Standard Test Method for Peel Strength (“T” Method) of Hook andLoop Touch Fasteners.

“Shear strength” (or “shear force”) refers to the resistance to forcesthat cause, or tend to cause, two contiguous parts of a body to sliderelatively to each other in a direction parallel to their plane ofcontact. That is, shear strength is the amount of force required to moveone surface relative to another surface when the two surfaces are pulledin opposite directions parallel to their plane of contact. Adhesiveshear force can be measured using the ASTM method referenced in the“Adhesives” section below. Shear force between mating surfaces of amechanical fastener can be measured using ASTM D5169-98 (2015)—StandardTest Method for Shear Strength (Dynamic Method) of Hook and Loop TouchFasteners.

FIG. 1 illustrates a nasogastric tube securement system 100 according toone embodiment of the present disclosure. By way of example only, thesystem 100 is shown as a kit 101 comprising four elements of the system100 all provided on one release liner 103. Additional details regardingrelease liners of the present disclosure are described in greater detailbelow under the section entitle, “Release Liners.” As shown in FIG. 1,the nasogastric tube securement system can include a base layer, sheetor dressing 102, a coupling layer, sheet or dressing 104, and one ormore additional auxiliary layers, sheets or tapes. The base layer 102and the coupling layer 104 can be flexible sheets.

Specifically, by way of example only, the system 100 is shown asincluding a first tape strip 106 and a second tape strip 108. The firsttape strip 106 can include securing means, e.g., a securing adhesive107, configured to adhere to the nasogastric tube (e.g., an outersurface thereof) and configured to be wrapped about at least a portionof a circumference of the nasogastric tube to mark a desired depth ofinsertion into a subject's nostril.

The second tape strip 108 can include a skin-contact adhesive 109 andcan be configured to be adhered to another portion of the subject's skin(e.g., on the face) to hold a portion of the length of the nasogastrictube out of the way to inhibit accidental tensions in the nasogastrictube or accidental removal of the nasogastric tube from the nostril ornasal cavity.

The first tape strip 106 and the second tape strip 108 are shown asbeing elongated and rectangular by way of example; however, it should beunderstood that the first tape strip 106 and the second tape strip 108can have any shape suitable for marking the nasogastric tube and foradhering a portion of the tube to the subject's skin, respectively.

With continued reference to FIG. 1, the base layer 102 can be configured(e.g., dimensioned, shaped, formed of appropriate materials, etc.) to beadhered to the skin on the top of a nose (e.g., a human nose). The baselayer 102 can include a first (e.g., bottom) major surface 110comprising a skin-contact adhesive 112 and a second (e.g., top) majorsurface 114 opposite the first major surface.

Additional details regarding securing adhesives and skin-contactadhesives of the present disclosure are described in greater detailbelow under the section entitled, “Adhesives.”

The base layer 102 can be shaped to be conducive to covering a nose, andparticularly, a human nose. By way of example only, the base layer 102of FIG. 1 has a generally triangular shape comprising a center portionthat can overlap and adhere to the bridge of a nose, and two side flankportions extending out from the center portion configured to overlap andadhere to the sides of a nose, providing a secure and reliable base forthe system 100. Other shapes are possible to achieve a stable and securebase, as described below with respect to FIGS. 5A and 5B. In addition,the base layer 102 may be provided in various sizes to accommodatedifferent populations, e.g., smaller sizes for children.

The coupling layer 104 can include a first bulbous end (or “first end”or “nose securing portion” or “base layer coupling portion”) 120; and aleg (or “nasogastric tube securing portion”) 122. In some embodiments,the coupling layer 104 consists essentially of the first end 120 and theleg 122. In some embodiments, the first end 120 can be referred to as“bulbous” because of its protruding and expanded areas or shapes,relative to the narrower leg 122.

The first end 120 can include coupling means configured to berepositionably coupled to the second major surface 114 of the base layer102. The leg 122 can be configured to secure a nasogastric tube, i.e.,can include securing means for reliably coupling the nasogastric tube.In some embodiments, it can be desirable for the leg 122 to not onlysecurely hold the nasogastric tube for a desired duration of time but toalso allow relatively easy removal of the nasogastric tube. As shown,the leg 122 connects to a lower end or portion of the first end 120 andis elongated along or parallel to a longitudinal direction D extendingdownwardly from the first end 120.

Furthermore, by way of example only, in some embodiments, the base layer102 and/or the coupling layer 104 (e.g., the first end 120) can includeone or more tabs 105, which can facilitate removal of the base layer 102and/or the coupling layer 104 from the release liner 103. In addition,or alternatively, such tabs 105 can enhance removal of the base layer102 from skin after use, and/or can enhance removal of the couplinglayer 104 from the base layer 102 during use (e.g., for repositioning asnecessary) or after use. To facilitate easy grasping of tabs 105, anadditional section of release liner may be provided under only theportion 105.

In the embodiment illustrated in FIG. 1, the first end 120 is wider thanthe leg 122 in a lateral, or transverse, direction L that is orientedsubstantially perpendicularly with respect to the longitudinal directionD. Said another way, in some embodiments, the first end 120 has a width(i.e., an ultimate lateral dimension) in the lateral direction L that isgreater than that of the leg 122. In some embodiments, as shown in FIG.1, the first end 120 can each be at least two times wider than the leg122. The wider first end 120 can ensure a sufficient coupling area andshear strength between the coupling layer 104 and the base layer 102,without requiring that the entire coupling layer 104 have this width,which could result in an overall large, cumbersome and bulky structure.As a result, the first end 120 is dimensioned for coupling to the baselayer 102, while the leg 122 is dimensioned for effectively wrapping (orfolding) about a circumference of a nasogastric tube to enhance thesecurity of the nasogastric tube. That is, the relative sizing betweenthe first end 120 and the leg 122 can ensure that the first end 120 canbe sized appropriately for coupling to the nose (i.e., sized to becoupled over the nose via the base layer 102) and can ensure that theleg 122 can be sufficiently narrow without adding bulk, complexity orreducing patient comfort. In addition, the relative sizing can ensurethat the leg 122 is sufficiently long (i.e., in the longitudinaldirection D) to avoid pressure on the nostril.

Said another way, in some embodiments, the first end 120 can have acentral longitudinal axis X, and the leg 122 can connect to the firstend 120 at a position that is located laterally with respect to thecentral longitudinal axis X of the first end 120 (i.e., connects to thefirst end 120 at a location that is not a lateral center of the firstend 120). In some embodiments, the first end 120 can be laterallysymmetrical about the central longitudinal axis X. However, due to thelaterally offset leg 122, the coupling layer 104 as a whole is notlaterally symmetrical. Rather, the coupling layer 104 is asymmetrical.

Furthermore, the leg 122 can be oriented substantially parallel withrespect to the central longitudinal axis X of the first end 120, asshown in FIG. 1. In addition, the leg 122 can have a centrallongitudinal axis Y that is substantially parallel to and spaced adistance from the central longitudinal axis X of the first end 120. Insome embodiments, the central longitudinal axis X of the first end 120can be oriented substantially along a bridge of a hose when the couplinglayer 104 is coupled to (i.e., in place on) the nose.

In some embodiments, as shown in FIG. 4C, which is described in greaterdetail below, the width of the first end 120 of the coupling layer 104and/or the width of the base layer 102 can be oriented, in use,substantially laterally with respect to a bridge of a nose when thesystem 100 is coupled to the nose.

In some embodiments, the leg 122 can be longer in the longitudinaldirection D than the first end 120 to ensure that the leg 122 hassufficient length to secure the nasogastric tube at a longitudinalposition that will not directly impinge on the nose, nostril, orotherwise, pull or cause tension on the first end 120 of the couplinglayer 104, the base layer 102, the nose, or the nostril.

In some embodiments, the coupling layer 104 is generally “p” shaped, orgenerally has “p” configuration, i.e., generally takes the shape of acapital or lowercase English letter “p.” For example, in suchembodiments, the leg 122 can connect to the first end 120 at a locationthat is laterally spaced from a lateral center of the first end 120.Specifically, in FIG. 1, the leg 122 connects to the first end 120 tothe left of a lateral center (or a central longitudinal axis) of thefirst end 120.

In some embodiments, the coupling layer 104 is generally “q” shaped, orgenerally has a “q” configuration, i.e., generally takes the shape of alowercase English letter “q.” That is, in some embodiments, the leg 122connects to the first end 120 to the right of a lateral center (or acentral longitudinal axis) of the first end 120 (see FIG. 6B, describedbelow).

In some embodiments, as shown in FIG. 1, the first end 120 of thecoupling layer 104 can extend laterally outwardly with respect to theleg 122, such that the leg 122 is located within the width of the firstend 120. However, this need not be the case, as shown in FIG. 6A,described below.

In some embodiments, the coupling layer 104 is generally “R” shaped, orgenerally has an “R” configuration, i.e., generally takes the shape of acapital English letter “R,” as shown in FIGS. 7A-7C, described ingreater detail below.

As shown in FIG. 1, in some embodiments, the leg 122 can be linear.Furthermore, in some embodiments, the leg 122 can have a uniform widthalong its length extending from the first end 120.

The coupling layer 104 can include a first major surface 130 configuredto be positioned toward the patient (i.e., toward the patient's skin andnose) and toward a nasogastric tube to be secured by the system 100, anda second major surface 134 configured to face away from the patient(i.e., away from the patient's skin and nose) and the nasogastric tube,the second major surface 134 being opposite the first major surface 130.The coupling layer 104 can include one or more adhesives on the firstmajor surface 130, such as the securing adhesive 132 shown in FIG. 1.For example, in some embodiments, the first major surface 130 caninclude a different adhesive in the region of the first end 120 than inthe region of the leg 122, but this need not be the case. In someembodiments, the first major surface 130 can include first couplingmeans located at least partially in the first end 120 configured forrepositionable coupling to the second major surface 114 of the baselayer 102, and second coupling means located at least partially in theleg 122 configured to secure a nasogastric tube. However, in someembodiments, the first major surface 130 of the coupling layer 104 caninclude one coupling means (e.g., one securing adhesive). In suchembodiments, the second major surface 114 of the base layer 102 can bemodified to include a release agent (e.g., in the form of a releaselayer, a release coating, or a combination thereof) configured torelease the securing adhesive on the first major surface 130 of thecoupling layer 104, such that the first end 120 of the coupling layer104 is repositionable on the base layer 102 as needed.

In some embodiments, as described below with respect to FIGS. 3A and 3B,a mechanical fastener can be employed (e.g., between the second majorsurface 114 of the base layer 102 and the first major surface 130 of thefirst end 120 of the coupling layer 104) in addition to the securingadhesive 132, or as an alternative thereto. For example, one matingsurface of a mechanical fastener can be employed on the first majorsurface 130 of the coupling layer 104, and the complementary matingsurface of the mechanical fastener can be employed on the second majorsurface 114 of the base layer 102 to achieve strong but repositionablecoupling between the base layer 102 and the coupling layer 104.

However, even though the first end 120 of the coupling layer 104 (andparticularly, the first major surface 130 thereof) and the base layer102 (and particularly, the second major surface 114 thereof) areconfigured such that the first end 120 of the coupling layer 104 isrepositionable on the base layer 102, the engagement (e.g., adhesion)between the first end 120 of the coupling layer 104 and the base layer102 also still needs to be sufficiently strong in order to providereliable securement of a nasogastric tube for the desired period oftime.

That is, whether an adhesive, a mechanical fastener, or another couplingmeans is employed between the base layer 102 and the coupling layer 104(i.e., the first end 120 thereof), the base layer 102 and the couplinglayer 104, and particularly, the second major surface 114 of the baselayer 102 and the first major surface 130 of the coupling layer 104,should be configured such that the peel force required to remove (i.e.,peel) the coupling layer 104 from the base layer 102 is relatively lowto allow easy repositioning as necessary, while the shear strengthbetween the layers is relatively high to ensure adequate securement ofthe nasogastric tube. The present inventors discovered that by employingbase layers and coupling layers specifically shaped and configured asdescribed herein, they were able to achieve this balance of mechanicalproperties.

As shown in FIG. 1 by way of example only, in some embodiments, the baselayer 102 can have a generally triangular shape, and particularly,generally has the shape of an equilateral triangle. The base layer 102also has rounded corners for enhanced patient comfort. However, the baselayer 102 can have any shape that is suitable for covering or wrappingover a nose, and particularly, the top of a nose. In some embodiments,the base layer 102 can have a shape that is suitable for covering asubstantial portion of a nose, including the bridge of the nose and atleast part of the lateral sides of the nose. Furthermore, in someembodiments, as shown in FIG. 1, the base layer 102 can have lateralsymmetry, which can enhance the coupling to a nose. However, generally,the base layer 102 is also shaped so as not to extend downwardly overthe tip or the nose or to otherwise interfere with a nasogastric tube tobe secured by the system 100.

FIGS. 5A and 5B illustrate two examples of alternative shapes for baselayers of the present disclosure. FIG. 5A shows a base layer 202 havinga generally trapezoidal shape that is wider at its base (i.e., theportion to be positioned toward the tip of the nose) than it is at itstop (i.e., the portion to be positioned away from the tip of the nose).FIG. 5B shows a base layer 302 having an irregular lobed shape that iswider at its base than at its top and that includes one or morescalloped rounded edges, which can enhance the conformability of thebase layer 302 to a nose and/or patient comfort. While FIGS. 5A and 5Bare illustrated to show other possible base layer shapes that can beemployed, the three illustrated shapes (i.e., in FIGS. 1, 5A and 5B) arenot exhaustive and other shapes that suitably cover the nose are alsopossible, including, but not limited to, oblong, circular,parallelogrammatic (e.g., square, rectangular), other suitable shapes,or combinations thereof. Any of the previous or following disclosureregarding base layers of the present disclosure refers to the base layer102 of FIG. 1 for simplicity, but it should be understood that any suchdisclosure can also equally apply to the base layers 202 and 302 ofFIGS. 5A and 5B.

As shown FIG. 1, in some embodiments, the first end 120 of the couplinglayer 104 can have a shape that mimics the shape of the base layer 102,while also generally being smaller than the base layer 102, such thatthe area of the first end 120 can be contained within the area of thebase layer 102 when the first end 120 is coupled to the base layer 102.Such a relationship between the shape and size of the first end 120 ofthe coupling layer 104 and the base layer 102 can enhance the couplingbetween the first end 120 and the base layer 102. The first end 120 ofFIG. 1 has a generally circular shape, and particularly is slightlyoblong, such that it is longer in the longitudinal direction D than itis wide in the lateral direction L. However, similar to the base layer102, the first end 120 of the coupling layer 104 can have any shapesuitable for coupling to the base layer 102 and for also covering orwrapping over at least a portion of a nose, and particularly, the top ofa nose. In some embodiments, the first end 120 of the coupling layer 104can have a shape that is suitable for covering a substantial portion ofa nose, including the bridge of the nose and at least part of thelateral sides of the nose. Furthermore, in some embodiments, as shown inFIG. 1, the first end 120 can have lateral symmetry (i.e., in thelateral direction L), which can enhance the coupling to a nose. Inaddition, the coupling layer 104 can be configured to extend down from abridge of the nose and over the front tip of the nose. Such aconfiguration can ensure that the nasogastric tube is secured in such away that limits lateral pulling or tension on the nasogastric tube thatcould cause pressure ulcers on the nostril.

FIGS. 6A-6C illustrate three examples of alternative shapes for couplinglayers of the present disclosure. FIG. 6A shows a coupling layer 204having a generally rectangular first end 220, and a leg 222 extendingdownwardly therefrom that connects to the first end 220 to the left of alateral center (i.e., is offset from the lateral center) of the firstend 220, generally forming a “p” configuration. Specifically, the leg222 connects to a left lateral half of a lower end of the first end 220.The leg 222 extends substantially perpendicularly with respect to thebottom edge of the generally rectangular first end 420.

By way of example, the first end 220 has lateral symmetry, and the leg222 is linear but does not have a uniform width in a longitudinaldirection extending from the first end 220. Rather, the leg 222 taperslongitudinally from the location at which it connects to the first end220 from a width equal to about half the width of the first end 220 to anarrower width at its outermost end. As a result, the leg 222 has avarying width that varies with respect to its longitudinal direction,and by way of example, the leg 222 of FIG. 6A is wider toward the firstend 220, and particularly, is widest where the leg 222 connects to thefirst end 220. Furthermore, the length of the first end 220 and the leg222 are about equal in the longitudinal direction. Unlike the couplinglayer 104 of FIG. 1, the first end 220 does not extend laterally on bothsides of the leg 222. Rather, the first end 220 only extends laterallyoutwardly with respect to the leg 222 on one side of the leg, andparticularly, on the right side. While the coupling layer 204 isdescribed as being “p” shaped, it should be understood that a mirrorimage of the coupling layer 204 can also be employed, generally having a“q” shape.

FIG. 6B shows a coupling layer 304 having a generally circular or oblongfirst end 320, and a leg 322 extending downwardly therefrom thatconnects to the first end 320 at a location located to the right of alateral center (i.e., is offset from the lateral center) of the firstend 320, generally forming a “q” configuration. Any disclosure hereinregarding the coupling layer 104 of FIG. 1 can equally apply to thecoupling layer 304 of FIG. 6B, and vice versa, except that the couplinglayer 304 of FIG. 6B has the leg 322 on its right side and is generally“q” shaped, rather than “p” shaped.

FIG. 6C shows a coupling layer 404 having a generally trapezoidal firstend 420 that is wider at its base (i.e., the lower end to be positionedtoward a tip of a nose), and a leg 422 extending downwardly therefromthat connects to the first end 420 to the left of a lateral center(i.e., is offset from the lateral center) of the first end 420,generally forming a “p” configuration. The leg 422 extends substantiallyperpendicularly with respect to the bottom edge of the generallytrapezoidal first end 420. By way of example, the first end 420 haslateral symmetry, the leg 422 is linear, and the leg 422 and isgenerally uniform in width along its length in the longitudinaldirection. The first end 420 extends at least partially laterally withrespect to the leg 422. While the coupling layer 404 is described asbeing “p” shaped, it should be understood that a mirror image of thecoupling layer 404 can also be employed, generally having a “q” shape.

FIG. 7A illustrates a coupling layer 504 having a generally circular oroblong first end 520; a first leg 522 extending downwardly therefromthat connects to the first end 520 to the left of a lateral center(i.e., is offset from the lateral center) of the first end 520; and asecond leg 523 extending outwardly from the first leg 522 at an acuteangle α with respect to a longitudinal direction D of the first leg 522along which the first leg 522 is elongated, generally forming an “R”shape. Specifically, the second leg 523 can be elongated along alongitudinal direction K that is oriented with respect to thelongitudinal direction D of the first leg 522 at the acute angle α.

Said another way, in some embodiments, the first end 520 of the couplinglayer 504 is laterally symmetrical about a central longitudinal axis X,wherein the first leg 522 connects to the first end 520 at a positionthat is located laterally with respect to the central longitudinal axisX of the first end 520, wherein the longitudinal direction D of thefirst leg is substantially parallel to and spaced from the centrallongitudinal axis X of the first end 520, and wherein the second leg 523is elongated along a longitudinal direction K that is oriented at anacute angle α with respect to the central longitudinal axis X of thefirst end 520.

As shown in FIG. 7A, in some embodiments, the second leg 523 can connectto the first end 520 adjacent the location at which the first leg 522connects to the first end 520. The first leg 522 and the second leg 523can together enhance the security of a nasogastric tube held by thesystem. For example, in some embodiments, each of the legs 522 and 523can be wrapped (e.g., sequentially) about at least a portion of acircumference of a nasogastric tube. In other embodiments, each of thelegs 522 and 523 can be configured to be folded over a nasogastric tubeand coupled to one another (e.g., via adhesive, mechanical fastener, orother suitable coupling means). In such embodiments, the second majorsurface 134 of the coupling layer 504, at least in the regions of thefirst and second legs 522 and 523, can include a release agent (e.g., alow adhesion backsize coating), as described above with respect to therelease agent 136 of FIG. 2A.

FIG. 7B illustrates a coupling layer 604 having a generally circular oroblong first end 620; a first leg 622; and a second leg 623 extendingoutwardly from the first leg 622 at an acute angle α with respect to alongitudinal direction D of the first leg 622 along which the first leg622 is elongated, generally forming an “R” shape. Specifically, thesecond leg 623 can be elongated along a longitudinal direction K that isoriented with respect to the longitudinal direction D of the first leg622 at the acute angle α. The coupling layer 604 is very similar to thecoupling layer 504 of FIG. 7A, except that the second leg 623 connectsto the first leg 622 at a location along the length of the first leg 622that is spaced a distance from the first end 620, such that the secondleg 623 does not directly connect to the first end 620.

FIG. 7C illustrates a coupling layer 704 having a generally square firstend 720 with rounded corners; a first leg 722; and a second leg 723extending outwardly from the first leg 722 at an acute angle α withrespect to a longitudinal direction D of the first leg 722 along whichthe first leg 722 is elongated, generally forming an “R” shape.Specifically, the second leg 723 can be elongated along a longitudinaldirection K that is oriented with respect to the longitudinal directionD of the first leg 722 at the acute angle α. The coupling layer 704 issubstantially the same as the coupling layer 604 of FIG. 7B, except thatthe first end 720 is substantially square.

While FIGS. 7A-7C each illustrate coupling layers having an “R”configuration, it should be understood that the coupling layers caninstead have the mirror image configuration of what is shown in FIGS.7A-7C, generally forming a backwards or reverse “R” configuration. Inaddition, while two legs are illustrated in the coupling layers 504, 604and 704 of FIGS. 7A-7C, it should be understood that as many legs asstructurally possible can be employed without overly hinderingnasogastric tube securement or adding unnecessary complexity. In someembodiments, two legs extending at least partially downwardly butseparated by the acute angle α can be preferred.

While FIGS. 6A-7B are illustrated to show other possible coupling layershapes that can be employed, the seven illustrated shapes (i.e., inFIGS. 1, 6A-6C and 7A-7C) are not exhaustive and other shapes, or othercombinations of first end shapes and leg configurations are alsopossible to provide suitable coupling between the first end of thecoupling layer and the base layer while also providing sufficientcoupling between the one or more legs and a nasogastric tube. Thus,various shapes can be employed as the first end, including, but notlimited to, trapezoidal, lobed, triangular, oblong, circular,parallelogrammatic (e.g., square, rectangular), other suitable shapes,or combinations thereof. Any of the previous or following disclosureregarding coupling layers of the present disclosure refers to thecoupling layer 104 of FIG. 1 for simplicity, but it should be understoodthat any such disclosure can also equally apply to the coupling layers204, 304 and 404 of FIGS. 6A-6C, as well as the coupling layers 504, 604and 704 of FIGS. 7A-7C.

With continued reference to FIG. 1, in some embodiments, the base layer102 can have a footprint area A, which is measured when the base layer102 is in a flat configuration as shown in FIG. 1, e.g., before beingapplied to a nose. This area A is the overall footprint that the baselayer 102 takes up on the release liner 103 and generally over a nose,when in use. The first end 120 of the coupling layer 104 can have afootprint area B. In some embodiments, the footprint area B of the firstend 120 can be at least 0.3 A (i.e., at least 30% of footprint area A);in some embodiments, at least 0.4 A; in some embodiments, at least 0.5A; in some embodiments, at least 0.6 A; in some embodiments, at least0.7 A; in some embodiments, at least 0.75 A; in some embodiments, atleast 0.8 A; in some embodiments, at least 0.85 A; in some embodiments,at least 0.9 A; and in some embodiments, at least 0.95 A. In someembodiments, the footprint area B of the first end 120 can be no greaterthan 0.98 A; in some embodiments, no greater than 0.97 A; in someembodiments, no greater than 0.95 A. Increasing the footprint area B ofthe first end 120 of the coupling layer 104, relative to the footprintarea A of the base layer 102, can enhance the coupling (e.g., shearstrength) between the first end 120 and the base layer 102, which canenhance the securement of a nasogastric tube.

As shown in FIG. 2A which illustrates a side cross-sectional view of oneembodiment of the base layer 102, in some embodiments, the base layer102 can include a backing 135 that provides the first major surface 110and the second major surface 114. In some embodiments, the base layer102 can include a multi-layer structure, including a plurality ofbackings 135, and can optionally include additional adhesives locatedbetween adjacent backings 135. In such embodiments, the first majorsurface 110 of the base layer 102 can be provided by a lowermostbacking, and the second major surface 114 of the base layer 102 can beprovided by an uppermost backing in the multi-layer structure. That is,while only one backing 135 is shown in FIG. 2A, it should be understoodthat as many backings 135 (and, optionally, adhesives therebetween) canbe employed in the base layer 102, as long as the exposed adhesive onthe first major surface 110 of the overall base layer 102 is askin-contact adhesive 112 suitable for being adhered to skin, andparticularly to the skin on the nose. Various additional detailsregarding backings of the present disclosure are described in greaterdetail below under the section entitled, “Backings.”

In addition, in some embodiments, the multi-layer concept can also beused in the configuration of the kit 101 of FIG. 1, where, for example,the base layer 102 and the coupling layer 104 can be provided alreadyoverlapped on the release liner 103 (e.g., where a release agent on atop surface of one layer can serve as the release liner for anotherlayer). In addition, or alternatively, in some embodiments, the kit 101can optionally include an extra coupling layer 104 that can be suppliedto guarantee an extra adjustment, if necessary, for a nasogastric tube.In some embodiments, the additional coupling layer 104, for example, canbe supplied directly under the first coupling layer 104, thereby takingup no additional footprint area of the kit 101. Furthermore, in someembodiments, the first tape strip 106 and the second tape strip 108 canbe provided in an overlapped configuration on the release liner 103. Thecross-sectional multilayer configuration of such overlapped embodimentswould be similar to the construction shown in FIG. 2B, which isdescribed in greater detail below. Furthermore, in some embodiments, thekit 101 can include multiple coupling layers 104 of different shapes,types and/or sizes, such that the kit 101 provides several options foruse, for example, depending on patient anatomy.

As shown in FIG. 2A, the base layer 102 can further include theskin-contact adhesive 112 on the first major surface 110, and a releaseagent (e.g., a release coating) 136 on the second major surface 114 ofthe backing 135. Such a release agent 136 can be selected to function asa release layer or liner for an adhesive (e.g., a securing adhesive)located on the first major surface 130 of the coupling layer 104, andparticularly, for an adhesive located on the first major surface 130 inthe first end 120 of the coupling layer 104. As further shown in FIG.2A, in some embodiments, the base layer 102 can further include arelease liner 138 (e.g., a paper liner comprising a release agent, e.g.,silicone, for the skin-contact adhesive 112). However, in someembodiments, as shown in FIG. 1, the base layer 102 may be provided onthe same release liner 103 as the rest of the system 100 and not includeits own dedicated release liner 138.

In some embodiments, the release agent 136 can include a low adhesion(low adhesion backsize, or LAB) coating provided on the second majorsurface 114 of the base layer 102 at least in a region positioned tocome into contact with the coupling layer 104. The low adhesion coatingcan allow the coupling layer 104 to be repositionable on the base layer102 to the extent necessary. A description of a low adhesion backingmaterial suitable for use with medical dressings of the presentdisclosure can be found in U.S. Pat. Nos. 5,531,855 and 6,264,976, whichare incorporated herein by reference in their entirety.

In some embodiments, the backing 135 can be formed of a stretchablematerial (e.g., a stretchable nonwoven, woven, film, or combinationthereof) that can provide gentle removal to minimize skin damage whenthe system 100 (and, particularly, the base layer 102 of the system 100)is removed. For example, in some embodiments, the base layer 102 caninclude a stretch release backing 135 (i.e., a backing 135 formed of astretch release material) and skin-contact adhesive 112, such that whilestretching, there is a distribution of tension force between the backing135, the adhesive 112, and the skin, providing adhesive failures andreducing the tension applied on the skin as the base layer 102 isremoved.

By way of example only, in some embodiments, the backing 135 and theskin-contact adhesive 112 can be provided by polyurethane stretchablenonwoven tape, such as the tape available as 3M™ CoTran™ 9699 Melt BlowPolyurethane Tape from 3M Company, St. Paul, Minn., any of the materialsA-H of Table 1 in the Examples section below, other suitabletapes/backings, or a combination thereof.

In some embodiments, it can be advantageous for the base layer 102 to beformed of a relatively stretchy (e.g., elastic, viscoelastic, etc.) andconformable material, while the coupling layer 104 is formed of arelatively non-stretchy (e.g., inelastic, rigid, etc.) material. Suchrelative material properties can enhance patient comfort and/orfacilitate removal of the base layer 102 from the skin, while alsoensuring enough tensile strength in the coupling layer 104 to securelyhold a nasogastric tube in a desired position without allowing thenasogastric tube to shift or cause undue pressure on the skin ornostril.

For example, in some embodiments, the base layer 102 can have a percentelongation at break (or maximum elongation) of at least 200%; in someembodiments, at least 250%; in some embodiments, at least 300%; in someembodiments, at least 400%; and in some embodiments, at least 500%.

In some embodiments, the coupling layer 104 can have a percentelongation at break of no greater than 100%; in some embodiments, nogreater than 80%; in some embodiments, no greater than 75%; and in someembodiments, no greater than 50%.

Percent elongation at break can be measured using any standard tensiletesting equipment known to those of ordinary skill in the art. Oneexample of tensile testing is described in the Examples section.

As shown in FIG. 2B, in some embodiments, the coupling layer 104 caninclude a multi-layer structure (e.g., multi-layer tape or multipletapes) comprising one or more backings 140 and one or more securingadhesives 132. As shown in FIG. 2B, the first major surface 130 of thecoupling layer 104 can be provided by one backing 140, and the firstmajor surface 130 can include a securing adhesive 132 configured torepositionably adhere to the release agent 136 on the second majorsurface 114 of the base layer 102, as well as adhere to a nasogastrictube (and, optionally, its own second major surface 134) to securelyhold a nasogastric tube in place. By way of example only, in theembodiment illustrated in FIG. 2B, the first major surface 130 isprovided by a first adhesive backing (e.g., tape) 140A, and the secondmajor surface 134 is provided by a second adhesive backing (e.g., tape)140B that is laminated over the first adhesive backing 140A. However, itshould be understood that the illustrated laminate structure need not beemployed and that the first major surface 130 and the second majorsurface 134 can be provided by one backing 140. While two backings 140and securing adhesives 132 are shown in FIG. 2B by way of example, itshould be understood that as few as one backing 140 and securingadhesive 132, or as many as structurally possible or necessary, can beemployed.

That is, as shown in FIG. 2B, in some embodiments, the coupling layer104 can be formed of the first backing 140A and a first securingadhesive 132A, and the second backing 140B and a second securingadhesive 132B that adheres the second backing 140B to the first backing140A. By way of example only, in some embodiments, the first backing140A and the first securing adhesive 132A can be provided by apolyethylene terephthalate (PET) nonwoven-acrylic adhesive tape, such asthe tape available as 3M™ Tan Spunlaced Nonwoven Medical Tape 9916, 3MCompany, St. Paul, Minn. In addition, in some embodiments, the secondbacking 140B and the second securing adhesive 132B can be provided by apolyethylene backing-acrylic adhesive tape, such as the tape availableas 3M™ Blenderm™ Surgical Tape 1525, 3M Company, St. Paul, Minn. Such alaminate structure can provide the necessary strength to the couplinglayer 104 to secure a nasogastric tube and keep it in the correctposition for the desired period of time. The first securing adhesive132A functions as the exposed securing adhesive that will be adhered tothe nasogastric tube. The specific tapes listed above are described byway of example; however, the coupling layer 104 can also include any ofthe materials I-M of Table 1 in the Examples section below, othersuitable tapes/backings, or a combination thereof.

As further shown in FIG. 2B, the coupling layer 104 can further includea release liner 148 (e.g., a paper liner comprising release agent forthe securing adhesive 132 exposed on the first major surface 130).However, in some embodiments, as shown in FIG. 1, the coupling layer 104may be provided on the same release liner 103 as the rest of the system100 and not include its own dedicated release liner 148.

Furthermore, in some embodiments, the second major surface 134 of thecoupling layer 104 can include a release agent similar to the releaseagent 136 of the base layer 102 of FIG. 2A, described above. Forexample, the second major surface 134 can include a low adhesion (lowadhesion backsize, or LAB) coating. Such a release agent on the secondmajor surface 134 of the coupling layer 104 (e.g., at least in theregion of one or more legs of the coupling layer 104) can facilitateunwrapping the coupling layer 104 during the process of removing thesystem 100 and decoupling the system 100 from a nasogastric tube.

While only one securing adhesive 132 is shown as being present on thefirst major surface 130 of the coupling layer 104, it should beunderstood that in some embodiments, the first major surface 130 of thecoupling layer 104 in at least a portion of the first end 120 caninclude a first securing adhesive (e.g., a less aggressive adhesive witha lower peel force on the second major surface 114 of the base layer102), and the first major surface 130 in at least a portion of the leg122 can include a second securing adhesive (e.g., a more aggressiveadhesive with a higher peel force on the outer surface of thenasogastric tube) that is different from the first securing adhesive.

Furthermore, while the base layer 102 shown in FIG. 2A is shown as beingthe same size (i.e., length) as the coupling layer 104 of FIG. 2B, thesetwo figures are not necessarily drawn to scale. Rather, as shown in FIG.1, the coupling layer 104 would generally be longer than the base layer102 (i.e., in the direction of the width of the page of FIGS. 2A and2B), such that the first end 120 of the coupling layer 104 can be sizedand positioned to overlap at least a portion of the base layer 102,while the leg 122 can extend beyond the area of the base layer 102 toaccess and secure a nasogastric tube, e.g., according to the relativesizes shown in FIG. 1.

FIGS. 3A and 3B illustrate a base layer 102′ and a coupling layer 104′,respectively, according to another embodiment of the present disclosure.For simplicity, no additional release liners are shown in FIGS. 3A and3B. In addition, each of the base layer 102′ and the coupling layer 104′are shown for simplicity as including only one backing—backings 135′ and140′, respectively. However, it should be understood that one or both ofthe base layer 102 and the coupling layer 104 can be a multi-layerstructure, as described above and as shown in FIG. 2B.

FIGS. 3A and 3B represent an example of repositionable coupling meansbetween the base layer 102′ and the coupling layer 104′ that includes amechanical fastener. As shown in FIG. 3A, the base layer 102′ includesthe backing 135′ having first major surface 110′ and second majorsurface 114′, and a skin-contact adhesive 112′ on the first majorsurface 110′. As shown in FIG. 3B, the coupling layer 104′ includes thebacking 140′ having first major surface 130′ and second major surface134′, and a securing adhesive 132′ on the first major surface 130′. Thecoupling layer 104′ further includes a first mating surface 142′ of amechanical fastener 143′ on the first major surface 130′, which can becoupled (e.g., laminated) to the first major surface 130′ via thesecuring adhesive 132′. By way of example only, the first mating surface142′ of the coupling layer 104′ is shown as being formed of loops orpile, however, other mechanical fastener features can be used.

As further shown in FIG. 3A, the base layer 102′ further includes asecond mating surface 144′ of the mechanical fastener 143′ on the secondmajor surface 114′ that is configured to reversibly engage the firstmating surface 142′ of the coupling layer 104′. By way of example only,the second mating surface 144′ is shown as being formed of hooks,however, other mechanical fastener features can be used. In someembodiments, the second mating surface 144′ of the mechanical fastener143′ can be provided on the base layer 102′ by laminating.

By way of example only, in some embodiments the backing 135′ andskin-contact adhesive 112′ can be provided by a polyethyleneterephthalate (PET)-acrylic adhesive tape, available under the tradedesignation 3M™ Spunlaced Polyester Nonwoven Medical Tape 1776 from 3MCompany, St. Paul, Minn. Other examples useful for providing the backing135′ and the skin-contact adhesive 112′, include, but are not limitedto, a polyethylene terephthalate (PET) nonwoven-acrylic adhesive tape,such as the tape available as 3M™ Tan Spunlaced Nonwoven Medical Tape9916 from 3M Company, St. Paul, Minn.; a rayon nonwoven tape, such asthe tape available as 3M™ Microporous Tan Rayon Nonwoven Medical Tape1533 from 3M Company, St. Paul, Minn.; a suitable elastic backing with agentle adhesive; or a combination thereof.

While the second mating surface 144′ is shown as being coextensive withthe second major surface 114′ of the base layer 102′, this need not bethe case. Rather, in some embodiments, the second mating surface 144′can have an area less than a total surface area of the second majorsurface 114′, e.g., such that the base layer 102′ includes a borderaround all edges of the second major surface 114′ that is free of thesecond mating surface 144′. Such embodiments can inhibit the potentiallyharder and more rigid mechanical fastener 143′ component from irritatingthe skin on the nose, by providing a buffer all around where the backing135′ is free of the second mating surface 144′.

As shown in FIG. 3B, in some embodiments, the first mating surface 142′may not be coextensive with the first major surface 130′ of the couplinglayer 104′. For example, in some embodiments, the securing adhesive 132′may be exposed in a portion of the first end 120′ (e.g., in someembodiments, in an area accounting for less than 10% of the total areaof the first major surface 130′ of the first end 120′, in someembodiments, less than 20%, or in some embodiments, less than 30%). Thiscan reduce the risk of the coupling layer 104′ being inadvertentlyremoved from the base layer 102′ during use, enhancing the couplingbetween the first end 120′ of the coupling layer 104′ and the base layer102′, while still allowing for repositioning of the coupling layer 104′on the base layer 102′ as needed. In some embodiments, however, theentire first end 120′ of the coupling layer 104′ can include the firstmating surface 142′ of the mechanical fastener 143′ (e.g., if themechanical fastener 143′ has a sufficiently aggressive engagementbetween the first mating surface 142′ and the second mating surface144′).

Furthermore, as shown in FIG. 3B, at least a portion of the leg 122′ canbe free of the mechanical fastener 143′, so that the securing adhesive132′ can be exposed for securing a nasogastric tube. In someembodiments, at least 80% of the leg 122′ is free of the mechanicalfastener 143′, in some embodiments, at least 90%, and in someembodiments, at least 95%.

Methods of Using Systems of the Present Disclosure to Secure aNasogastric Tube

FIGS. 4A-4J illustrate a method of securing a nasogastric tube using thenasogastric tube securement system 100 of FIG. 1. Before inserting anasogastric tube T into a subject's nose, the length of the tube to beinserted to reach a desired depth can be measured. Then, the first tapestrip 106 can be wrapped about a nasogastric tube T (e.g., about acircumference thereof) to mark the measured length, e.g., by adheringthe securing adhesive 107 to the outer surface of the nasogastric tube Tand continuing to wrap the first tape strip 106 over itself. Then, asshown in FIG. 4A, the nasogastric tube T can be inserted into a nostrilto the desired depth (see FIG. 4B).

As shown in FIG. 4B, the base layer 102 can be applied to the subject'snose, i.e., to cover a substantial portion of the top surface of thenose. Particularly, the skin-contact adhesive 112 on the first majorsurface 110 of the base layer 102 can be adhered to the skin on the topof the nose.

As shown in FIG. 4C, the first end 120 of the coupling layer 104 canthen be applied to the base layer 102. As shown in FIG. 4C, the securingadhesive 132 can be used to adhere the first major surface 130 of thefirst end 120 of the coupling layer 104 to the second major surface 114of the base layer 102. Alternatively or additionally, as shown in FIGS.3A and 3B, the first mating surface 142′ of the mechanical fastener 143′on the first major surface 130′ of the coupling layer 104′ can beengaged with the second mating surface 144′ on the second major surface114′ of the base layer 102′. The first end 120 of the coupling layer 104can be positioned on the base layer 102 in such a way that the first end120 is positioned predominantly within the area of the base layer 102and is generally aligned with the base layer 102.

As shown in FIGS. 4C and 4D, the first major surface 130 of the leg 122(or plurality of legs, if more than one leg is employed, as shown inFIGS. 7A-7C) can be positioned in contact with at least a portion of thenasogastric tube by wrapping (e.g., spiraling) the leg 122 around thenasogastric tube, with the first major surface 130 toward thenasogastric tube. In some embodiments, the leg 122 can be secured to thenasogastric tube T and optionally also to its second major surface 134.Alternatively, in embodiments employing more than one leg, the legs canbe folded toward one another (e.g., first major surfaces 130 toward oneanother) over the nasogastric tube T and secured to one another aboutthe nasogastric tube T, e.g., by adhesive, mechanical fastener, oranother suitable coupling means. In such embodiments, the legs can becoupled (e.g., adhered) to the nasogastric tube as well as to eachother.

As shown in FIG. 4E, the second tape strip 108 can be used to adhereexcess length of the nasogastric tube T to the patient's skin (e.g.,face) in such a way that keeps the nasogastric tube T out of the way andinhibits unnecessary tensions or pulling forces on the nasogastric tubeT. The remainder of the nasogastric tube T can then be threaded behindthe patient's ear.

The system 100 as shown in FIG. 4E is therefore fully secured and canremain as shown until repositioning of the coupling layer 104 isnecessary or until the system 100 needs to be removed or changed. FIGS.4F and 4G illustrate how the first end 120 (and particularly, the firstmajor surface 130 thereof) can be repositionable on the second majorsurface 114 of the base layer 102 while the rest of the coupling layer104 remains in place on the nasogastric tube T and undisturbed. Thefirst end 120 can then be readjusted as necessary (e.g., to remove anypressures on a nostril) and replaced back on the base layer 102.

FIGS. 4H-4J illustrate how the system 100 can be removed, e.g., when itis desired to remove the nasogastric tube T. First, if employed, thesecond tape strip 108 can be peeled from the patient's skin. Then, asshown in FIG. 4H, a portion of the leg 122 can be grasped, and the leg122 can be unwrapped from around the nasogastric tube T. As shown inFIG. 4I, the first end 120 of the coupling layer 104 can be lifted offof the base layer 102, and the whole coupling layer 104 can be removed(and disposed). While removing the leg 122 first can provide a lesscumbersome removal method for removing the coupling layer 104, the firstend 120 can be removed first instead. As shown in FIG. 4J, then only thebase layer 102 remains on the nose. Then, in embodiments employing astretch release material in the base layer 102, a corner or edge of thebase layer 102 can be grasped, as shown in FIG. 4J, and pulled in orderto gently remove the base layer 102 from the nose, reducing the risk ofskin damage and increasing patient comfort. In embodiments not employingstretch release material in the base layer 102, the base layer 102 canbe simply peeled from the nose.

Backings

Suitable backings for base layers and coupling layers of the presentdisclosure can include, but are not limited to, one or more of a fabric,a woven fibrous web, a nonwoven fibrous web, a knit, a polymeric film,other familiar dressing materials, or combinations thereof. In someembodiments, the backing materials can include polymeric elastic films(e.g., transparent or non-transparent), and can include, but are notlimited to, films formed of elastomeric polyurethanes, co-polyesters,polyethylenes, or combinations thereof. The backing can be a highmoisture vapor permeable film, i.e., a backing with a relatively highmoisture vapor transmission rate (MVTR). U.S. Pat. No. 3,645,835describes methods of making such films and methods for testing theirpermeability. The backing can be constituted of natural or syntheticsources of raw materials.

The backings of the present disclosure advantageously should transmitmoisture vapor at a rate equal to or greater than human skin. In someembodiments, the backing can be adhesive-coated. In such embodiments,the adhesive-coated backing can transmit moisture vapor at a rate of atleast 300 g/m²/24 hrs/37° C./100-10% RH, and in some embodiments, atleast 700 g/m²/24 hrs/37° C./100-10% RH. The backing is generallyconformable to anatomical surfaces. As such, when the backing is appliedto an anatomical surface, such as a nose, it conforms to the surfaceeven when the surface is moved.

The backing can be a flexible material. For example, the backing can bea film, paper, woven, knit, foam, nonwoven material, or a combinationthereof, or one or more layers of film, paper, woven, knit, foam,nonwoven, or a combination thereof. In some embodiments, it can bedesirable that at least a portion of the backing is formed of atransparent material to allow for viewing of underlying skin, a medicaldevice, and/or a target site.

By way of example only, in some embodiments, the backing of a base layerof the present disclosure can be formed of a film available under thetrade designation TEGADERM® from 3M Company, St. Paul, Minn.

Release Liners

Release liners suitable for use with the systems of the presentdisclosure can include, but are not limited to, kraft papers,polyethylene, embossed polyethylene, polypropylene, polyester, orcombinations thereof. Such liners can be coated with release agents,such as fluorochemicals, silicones, or other suitable low surface energymaterials. Other adhesives and release liner combinations known to thoseof ordinary skill in the art can also be employed in the systems of thepresent disclosure. Examples of commercially available silicone coatedrelease papers are POLYSLIK™, silicone release papers available fromRexam Release (Bedford Park, Ill.) and silicone release papers suppliedby LOPAREX (Willowbrook, Ill.). Other non-limiting examples of suchrelease liners commercially available include siliconized polyethyleneterephthalate films, commercially available from H. P. Smith Co., andfluoropolymer coated polyester films, commercially available from 3MCompany (St. Paul) under the brand “SCOTCHPAK™” release liners.

Adhesives

As described above, the securing adhesives of the present disclosure(e.g., the securing adhesive 132 or 107 of FIG. 1 configured to beadhered a nasogastric tube) can have an adhesion that is higher than theskin-contact adhesives of the present disclosure (e.g., the skin-contactadhesive 112 or 109 of FIG. 1). In some embodiments, the securingadhesive and the skin-contact adhesive may be of the same or similarclasses of adhesive, but have different adhesion levels. For example,the securing adhesive and/or the skin-contact adhesive may be anacrylate, silicone, urethane, hydrogel, hydrocolloid, natural rubber, orsynthetic rubber. Adhesion can also be tuned through changes in adhesivecomposition, adhesive thickness, or adhesive surface area (e.g., byemploying a pattern-coated adhesive).

“Adhesion” refers to the force required to separate an adhesive from anunderlying substrate. Adhesion can be measured in a number of ways. Forexample, adhesion can be defined by peel force or shear force. In someembodiments, adhesion can be defined by peel adhesion using ASTMD3330/D3330M-04 (2010). In some embodiments, adhesion can be defined byshear adhesion using ASTM D3654M-06 (2011). Adhesion is dependent on thespecific substrate being adhered to, as well as the time thepressure-sensitive adhesive (PSA) is allowed to dwell on the substrate.

For example, typical peel adhesion values exhibited bypressure-sensitive adhesives in medical dressings maybe in the range of20 to 300 g/cm as measured from stainless steel. In some embodiments, atleast 10% higher peel adhesion, as measured by ASTM D3330/D3330M-04(2010), of the securing adhesive over the skin-contact adhesive mayrealize the benefit of both securing to a nasogastric tube, whileproviding gentle adhesion to the skin.

In some embodiments, the securing adhesive can be an acrylate adhesiveand the skin-contact adhesive can be a silicone adhesive. The term“acrylate” or “acrylate-based” or “acrylate-containing” refers tomonomeric acrylic or methacrylic esters of alcohols. Acrylate andmethacrylate monomers are referred to collectively herein as “acrylate”monomers. Materials that are described as “acrylate-based” or“acrylate-containing” contain at least some acrylate monomers and maycontain additional co-monomers.

Acrylate adhesives are well suited for securing adhesive dressings tomedical articles (e.g., nasogastric tubes), or skin. The adhesion can bemanipulated to have high adhesion or low adhesion. Generally, theadhesion between acrylate adhesives and another material will increaseover time. This property makes acrylate adhesives well suited as thesecuring adhesive which is intended to secure a nasogastric tube.

Suitable acrylate adhesives that can be applied to skin such as theacrylate copolymers are described in U.S. Pat. No. RE 24,906, thedisclosure of which is hereby incorporated by reference. In particular,a 97:3 iso-octyl acrylate:acrylamide copolymer. Another acrylateadhesive is a 70:15:15 isooctyl acrylate:ethyleneoxide acrylate:acrylicacid terpolymer, as described in U.S. Pat. No. 4,737,410 (Example 31),the disclosure of which is hereby incorporated by reference. Otheruseful acrylate adhesives are described in U.S. Pat. Nos. 3,389,827,4,112,213, 4,310,509, and 4,323,557, the disclosures of which areincorporated herein by reference.

The term “silicone” or “silicone-based” or “silicone-containing” refersto polymers that contain units with dialkyl or diaryl siloxane (—SiR₂O—)repeating units. The silicone-based polymers may be segmented copolymersor polysiloxanes polymers. The terms silicone and siloxane are usedinterchangeably.

Generally, silicone adhesives are able to effectively secure dressingsand tape to skin and upon removal from the skin produce little or noskin damage. Typically, silicone adhesives do not adhere well topolymer-based substrates, like tubing or hardgoods, for example that areoften present in nasogastric tubes. Thus, lack of strong adhesion tomedical devices/tubing combined with the gentle removal of siliconeadhesives from skin make these adhesives well suited as the skin-contactadhesive of the present disclosure.

Examples of suitable silicone adhesive systems can include, but are notlimited to, products available under the following trade designations:Dow Corning MG 7-9850, Wacker SILPURAN® 2110 and 2130, BluestarSILBIONE® RT Gel 4317 and 4320, Nusil MED-6345 and 6350. Other examplesof suitable silicone adhesives are disclosed in PCT PublicationsWO2010/056541, WO2010/056543 and WO2010/056544, the disclosures of whichare incorporated herein by reference.

For skin-contact adhesives, it is desirable that the adhesive is able totransmit moisture vapor at a rate greater to or equal to that of humanskin. While such a characteristic can be achieved through the selectionof an appropriate adhesive, it is also contemplated that other methodsof achieving a high relative rate of moisture vapor transmission may beused, such as perforating the adhesive or pattern coating the adhesive,as described in U.S. Pat. No. 4,595,001 and U.S. Pat. App. Pub.2008-0233348 (now U.S. Pat. No. 7,947,366), the disclosures of which areincorporated herein by reference. Each of the securing or skin-contactadhesive can optionally be applied in a discontinuous manner.

Each embodiment shown in the figures is illustrated as a separateembodiment for clarity in illustrating a variety of features of thenasogastric tube securement systems of the present disclosure. However,it should be understood that any combination of elements and features ofany of the embodiments illustrated in the figures and described hereincan be employed in the nasogastric tube securement systems of thepresent disclosure.

In addition, various other features and elements can be employed in thenasogastric tube securement systems of the present disclosure, such asthose disclosed in co-pending U.S. Application Nos. 62/208,055;62/208,060; 62/208,065; and 62/208,069, each of which is incorporatedherein by reference in its entirety.

The following embodiments are intended to be illustrative of the presentdisclosure and not limiting.

Embodiments

1. A nasogastric tube securement system, the system comprising:

-   -   a base layer configured to be adhered to a nose, the base layer        having a first major surface comprising a skin-contact adhesive        and a second major surface opposite the first major surface; and    -   a coupling layer comprising        -   a first end comprising coupling means configured to be            repositionably coupled to the second major surface of the            base layer, and        -   a leg connected to and extending from the first end, the leg            being elongated along a longitudinal direction, the leg            being configured to secure a nasogastric tube;        -   wherein the leg connects to the first end at a position that            is located toward a lateral side of the first end, relative            to a lateral center of the first end; and        -   wherein the first end is wider than the leg in a lateral            direction that is oriented substantially perpendicularly            with respect to the longitudinal direction.

2. The system of embodiment 1, wherein the base layer has a footprintarea of A, and wherein the first end has a footprint area of at least0.3 A.

3. The system of embodiment 1 or 2, wherein the first end of thecoupling layer is symmetrical about the lateral center.

4. The system of any of embodiments 1-3, wherein the leg of the couplinglayer connects to the first end of the coupling layer at a location thatis not a lateral center of the first end.

5. The system of any of embodiments 1-4, wherein the first end of thecoupling layer is symmetrical about a central longitudinal axis, andwherein the leg connects to the first end at a position that is locatedlaterally with respect to the central longitudinal axis of the firstend.

6. The system of embodiment 5, wherein the longitudinal direction of theleg is oriented substantially parallel to the central longitudinal axisof the first end.

7. The system of embodiment 5 or 6, wherein the leg has a centrallongitudinal axis, and wherein the central longitudinal axis of the legis substantially parallel to and spaced a lateral distance from thecentral longitudinal axis of the first end.

8. The system of any of embodiments 5-7, wherein the centrallongitudinal axis of the first end is oriented substantially along abridge of the nose when the coupling layer is coupled to the nose.

9. The system of any of embodiments 1-8, wherein the coupling layer isasymmetrical.

10. The system of any of embodiments 1-9, wherein the coupling layer hasa “p” or a “q” configuration.

11. The system of any of embodiments 1-10, wherein the longitudinaldirection is oriented substantially along or parallel to a longitudinaldirection of a nasogastric tube to be secured by the system.

12. The system of any of embodiments 1-11, wherein the longitudinaldirection is oriented substantially along or parallel to a bridge of thenose when the system is coupled to the nose.

13. The system of any of embodiments 1-12, wherein the width of thefirst end of the coupling layer is oriented substantially laterally withrespect to a bridge of the nose when coupled to the nose.

14. The system of any of embodiments 1-13, wherein the coupling layerconsists essentially of the first end and the leg.

15. The system of any of embodiments 1-14, wherein the leg of thecoupling layer is longer in the longitudinal direction than the firstend.

16. The system of any of embodiments 1-15, wherein the first end of thecoupling layer extends laterally outwardly with respect to the leg ofthe coupling layer, such that the leg is located within the width of thefirst end.

17. The system of any of embodiments 1-16, wherein the leg of thecoupling layer is linear.

18. The system of any of embodiments 1-17, wherein the leg of thecoupling layer has a uniform width.

19. The system of any of embodiments 1-18, wherein the leg of thecoupling layer has a varying width that varies with respect to thelongitudinal direction.

20. The system of embodiment 19, wherein the leg is widest where the legconnects to the first end.

21. The system of embodiment 19 or 20, wherein the leg is wider towardthe first end.

22. The system of any of embodiments 1-21, wherein the first end of thecoupling layer has a footprint area of at least 0.5 A.

23. The system of any of embodiments 1-22, wherein the base layer has atleast one of a generally triangular shape, a generally trapezoidalshape, and a lobed shape.

24. The system of any of embodiments 1-23, wherein the base layer haslateral symmetry.

25. The system of any of embodiments 1-24, wherein the first end of thecoupling layer has a shape that mimics the shape of the base layer.

26. The system of any of embodiments 1-25, wherein the first end of thecoupling layer has at least one of a generally trapezoidal shape, agenerally rectangular shape, a generally square shape, a generallycircular shape, and an oblong shape.

27. The system of any of embodiments 1-26, wherein the leg of thecoupling layer is a first leg, and further comprising a second legextending outwardly from the first leg at an acute angle with respect tothe longitudinal direction of the first leg.

28. The system of embodiment 27, wherein the first leg has a lengthoriented along its longitudinal direction, and wherein the second legconnects to the first leg at a location along the length of the firstleg that is spaced a distance from the first end.

29. The system of embodiment 27, wherein the second leg connects to thefirst end adjacent the location at which the first leg connects to thefirst end.

30. The system of any of embodiments 27-29, wherein the second leg iselongated along a longitudinal direction that is oriented at an acuteangle with respect to the longitudinal direction of the first leg.

31. The system of any of embodiments 27-30, wherein the first end of thecoupling layer is laterally symmetrical about a central longitudinalaxis, wherein the first leg connects to the first end at a position thatis located laterally with respect to a central longitudinal axis of thefirst end, wherein the longitudinal direction of the first leg issubstantially parallel to and spaced from the central longitudinal axisof the first end, and wherein the second leg is elongated along alongitudinal direction that is oriented at an acute angle with respectto the central longitudinal axis of the first end.

32. The system of any of embodiments 1-31, wherein the base layer has apercent elongation of at least 200%.

33. The system of any of embodiments 1-32, wherein the coupling layerhas a percent elongation of no greater than 50%.

34. The system of any of embodiments 1-33, wherein the coupling layerhas a percent elongation of no greater than 100%.

35. The system of any of embodiments 1-34, wherein the base layer isformed of a stretch release material.

36. The system of any of embodiments 1-35, wherein the coupling layerincludes a first major surface configured to be coupled to the secondmajor surface of the base layer, the first major surface comprising anadhesive, and a second major surface opposite the first major surface,wherein the second major surface of at least a portion of the couplinglayer includes a release agent for the adhesive.

37. The system of any of embodiments 1-36, wherein the coupling layerincludes a first major surface, wherein the coupling layer furtherincludes an adhesive on the first major surface, and wherein the secondmajor surface of the base layer includes a release agent for theadhesive on the first major surface of the coupling layer.

38. The system of any of embodiments 1-37, wherein the coupling layerincludes a first major surface, wherein the coupling layer includes afirst mating surface of a mechanical fastener on the first majorsurface, and wherein the second major surface of the base layercomprises a second mating surface of the mechanical fastener configuredto engage the first mating surface on the first major surface of thefirst end of the coupling layer.

39. A kit comprising:

-   -   the nasogastric tube securement system of any of the preceding        embodiments, and    -   a release liner,    -   wherein the base layer and the coupling layer of the nasogastric        tube securement system are provided together on the release        liner.

40. The kit of embodiment 39, further comprising:

-   -   a first tape strip provided on the release liner, the first tape        strip comprising a securing adhesive and configured to be        wrapped about at least a portion of a circumference of the        nasogastric tube.

41. The kit of embodiment 40, further comprising:

-   -   a second tape strip provided on the release liner, the second        tape strip comprising a skin-contact adhesive and configured to        be adhered to another portion of the subject's skin.

42. A method of securing a nasogastric tube, the method comprising:

-   -   providing the nasogastric tube securement system of any of        embodiments 1-38;    -   providing a nasogastric tube that has been inserted into a        subject's nostril to a desired depth;    -   adhering the base layer to the top of a subject's nose via the        skin-contact adhesive on the first major surface of the base        layer;    -   coupling the first major surface first end of the coupling layer        to the second major surface of the base layer; and    -   securing the leg of the coupling layer to the nasogastric tube.

43. The method of embodiment 42, wherein securing the leg of thecoupling layer to the nasogastric tube includes wrapping the leg aboutat least a portion of a circumference of the nasogastric tube.

44. The method of embodiment 42 or 43, further comprising repositioningat least a portion of the first end of the coupling layer on the baselayer.

45. The method of any of embodiments 42-44, further comprising:

-   -   marking the nasogastric tube to form a mark; and    -   inserting the nasogastric tube into the subject's nostril up to        the mark.

46. The method of any of embodiments 42-45, wherein marking thenasogastric tube includes wrapping a tape strip about at least a portionof a circumference of the nasogastric tube.

47. The method of any of embodiments 42-46, further comprising securinga portion of the nasogastric tube to another portion of the subject'sbody with a tape strip.

It is to be understood that the invention is not limited in itsapplication to the details of construction and the arrangement ofcomponents set forth in the above description or illustrated in theaccompanying drawings. The invention is capable of other embodiments andof being practiced or of being carried out in various ways. Also, it isto be understood that the phraseology and terminology used herein is forthe purpose of description and should not be regarded as limiting. It isto be further understood that other embodiments may be utilized, andstructural or logical changes may be made without departing from thescope of the present disclosure.

The embodiments described above and illustrated in the figures arepresented by way of example only and are not intended as a limitationupon the concepts and principles of the present disclosure. As such, itwill be appreciated by one having ordinary skill in the art that variouschanges in the elements and their configuration and arrangement arepossible without departing from the spirit and scope of the presentdisclosure.

All references and publications cited herein are expressly incorporatedherein by reference in their entirety into this disclosure.

The following working examples are intended to be illustrative of thepresent disclosure and not limiting.

EXAMPLES

Materials

Materials utilized in the Examples are shown in Table 1.

TABLE 1 Materials List Material Description Source A - Foam Tape 3M ™Polyethylene Foam Medical Tape 1774W, 3M Company, 510 micron, closedcell, polyethylene foam St. Paul, MN backing, coated with 60 micronthick pressure sensitive acrylate adhesive. B - PU-NW Tape 3M ™ CoTran ™9699 Melt Blown Polyurethane 3M Company, Tape: 254 micron thickpolyurethane/polyethylene St. Paul, MN backing coated with a gentlemedical acrylate adhesive C - PU Film Tape 3M ™ Polyurethane Tape 9834;20, micron 3M Company, polyurethane film with 25 micron thick gentle St.Paul, MN medical acrylate adhesive D - coPET Film 3M ™ Steri-Drape ™ 2incise drape: 3M Company, Drape 25 micron thick elastomeric copolyesterSt. Paul, MN backing coated with 51 micron thick pressure sensitiveacrylate adhesive. E - Si Film SILPURAN ™ Film 2030; medical gradesilicone Wacker Chemie AG, film, 100 micron thick Munich Germany F- PETape 3M ™ Blenderm ™ Surgical Tape 1525 - 3M Company, Polyethylenebacking coated with gentle medical St. Paul, MN acrylate adhesive G -LDPE Film 3M ™ Steri-Drape ™ incise drape: 30 micron thick 3M Company,Drape low density polyethylene backing coated with 51 St. Paul, MNmicron thick pressure sensitive acrylate adhesive H - coPET-AM 3M ™Ioban ™ 2 Antimicrobial Incise Drape; 25 3M Company, Drape micron thickelastomeric copolyester backing St. Paul, MN coated with 51 micron thickiodophor impregnated (antimicrobial) pressure sensitive acrylateadhesive I - PET-NW Tape 3M ™ Spunlaced Polyester Nonwoven Medical 3MCompany, Tape 1776: polyester backing, coated with a St. Paul, MNmedical, pressure sensitive acrylate adhesive J- RA-NW Tape 3M ™ RayonAcetate Woven Medical Tape 1538; 3M Company, Rayon acetate woven clothbacking coated with a St. Paul, MN medical, pressure sensitive acrylateadhesive K- RA-MP NW 3M ™ MICROPORE 1530 Surgical Tape; 3M Company, Tapemicroporous rayon nonwoven backing coated with St. Paul, MN a medical,pressure sensitive acrylate adhesive L - CAT Tape 3M ™ Cloth AdhesiveTape 2950; high strength 3M Company, cotton backing coated with amedical, pressure St. Paul, MN sensitive acrylate adhesive M-NW fiberstrip 3M ™ Steri-Strip Skin Closure 1548; nonwoven 3M Company, backing,fiber reinforced with a medical, pressure St. Paul, MN sensitiveacrylate adhesiveTest MethodsTensile Test Method

Percent elongation was measured using a Universal test machine availablefrom Kratos Industrial Equipment Ltda., BR, model K2000MP with a loadcell of 20 kgf (196 N), depending on the properties of the backing to betested, and with the gauge distance and the kart speed set according tothe backing characteristics, as set forth in Table 2 below.

TABLE 2 Gauge Distance and Test Speed for Elongation Testing Distancebetween Conditions gauges Test speed <100% Elongation 100 mm 100 mm/minbetween 100-400% 50 mm 200 mm/min >400% 20 mm 200 mm/minResultsTensile Strength & Percent Elongation

Various backings or tapes useful for base layers and coupling layers ofthe present disclosure were tested according to the Tensile Test Methodto determine the Tensile Strength (kgf; N) and Percent Elongation atbreak (%). Examples 1-8 represent relatively elastic backings having apercent elongation of at least 100% that can be used as base layers ofthe present disclosure. Examples 9-13 represent relatively non-elasticbackings having a percent elongation of less than 100% that can be usedas coupling layers of the present disclosure. Results are shown inTables 3 and 4.

TABLE 3 Tensile Strength & Percent Elongation for Base Layer backingsTensile Exam- Strength at Elongation ple Base Layer Backing break kgf(N) max. (%) 1 A - Foam Tape (n = 10) 2.36 (23.1 N) 491.14 2 B - PU-NWTape (n = 10) 2.35 (23.0 N) 485.54 3 C - PU Film Tape (n = 10) 3.31(32.5 N) 586.49 4 D - coPET Film Drape (n = 10) 2.62 (25.7 N) 717.65 5E - Si Film (n = 6) 0.98 (9.6 N) 472.48 6 F - PE Tape (n = 10) 4.21(41.3 N) 204.32 7 G - LDPE Film Drape (n = 10) 1.86 (18.2 N) 229.46 8H - coPET-AM Drape (n = 10) 3.07 (30.1 N) 835.55

TABLE 4 Tensile Strength & Percent Elongation for Coupling Layerbackings Tensile Exam- Strength at Elongation ple Coupling Layer Backingbreak kgf (N) max. % 9 I - PET-NW Tape (n = 10) 8.29 (81.3 N) 41.58 10J - RA-NW Tape (n = 10) 16.54 (162.2 N) 21.20 11 K - RA-MP NW Tape (n =10) 3.58 (35.1 N) 13.02 12 L - CAT Tape (n = 9) 13.65 (133.9 N) 5.90 13M - NW fiber strip (n = 10) 10.33 (101.3 N) 35.40

Various features and aspects of the present disclosure are set forth inthe following claims.

What is claimed is:
 1. A nasogastric tube securement system, the systemcomprising: a base layer configured to be adhered to a nose, the baselayer having a first major surface comprising a skin-contact adhesiveand a second major surface opposite the first major surface comprising arelease coating; and a coupling layer comprising: a first end comprisingan adhesive, to be repositionably coupled to the second major surface ofthe base layer, and a leg connected to and extending from the first end,the leg being elongated along a longitudinal direction, the legconfigured to secure a nasogastric tube; wherein the leg connects to thefirst end at a position that is located toward a lateral side of thefirst end, relative to a lateral center of the first end; and whereinthe first end is wider than the leg in a lateral direction that isoriented substantially perpendicularly with respect to the longitudinaldirection.
 2. The system of claim 1, wherein the base layer has afootprint area of A, and wherein the first end of the coupling layer hasa footprint area of at least 0.3 A.
 3. The system of claim 1, whereinthe first end of the coupling layer is symmetrical about the lateralcenter.
 4. The system of claim 1, wherein the first end of the couplinglayer is symmetrical about a central longitudinal axis, and wherein theleg connects to the first end at a position that is located laterallywith respect to the central longitudinal axis of the first end.
 5. Thesystem of claim 1, wherein the coupling layer has a “p” or a “q”configuration.
 6. The system of claim 1, wherein the leg of the couplinglayer is longer in the longitudinal direction than the first end.
 7. Thesystem of claim 1, wherein the leg of the coupling layer is linear. 8.The system of claim 1, wherein the leg of the coupling layer has auniform width.
 9. The system of claim 1, wherein the leg of the couplinglayer has a varying width that varies with respect to the longitudinaldirection.
 10. The system of claim 1, wherein the leg of the couplinglayer is a first leg, and further comprising a second leg extendingoutwardly from the first leg at an acute angle with respect to thelongitudinal direction of the first leg.
 11. The system of claim 1,wherein the base layer has a percent elongation of at least 200%, andwherein the coupling layer has a percent elongation of no greater than50%.
 12. The system of claim 1, wherein the base layer is formed of astretch release material.
 13. The system of claim 1, wherein thecoupling layer includes a first major surface configured to be coupledto the second major surface of the base layer, the first major surfaceof the coupling layer comprising the adhesive, and a second majorsurface opposite the first major surface of the coupling layer, whereinthe second major surface of at least a portion of the coupling layerincludes a release agent for the adhesive.
 14. The system of claim 1,wherein the coupling layer includes a first major surface, wherein thecoupling layer further includes the adhesive on the first major surface,and wherein the second major surface of the base layer includes arelease agent for the adhesive on the first major surface of thecoupling layer.
 15. The system of claim 1, wherein the coupling layerincludes a first major surface, wherein the coupling layer includes afirst mating surface of a mechanical fastener on the first majorsurface, and wherein the second major surface of the base layercomprises a second mating surface of the mechanical fastener configuredto engage the first mating surface on the first major surface of thefirst end of the coupling layer.
 16. A kit comprising: the nasogastrictube securement system of claim 1, and a release liner, wherein the baselayer and the coupling layer of the nasogastric tube securement systemare provided together on the release liner.
 17. A method of securing anasogastric tube, the method comprising: providing the nasogastric tubesecurement system of claim 1; providing a nasogastric tube that has beeninserted into a subject's nostril to a desired depth; adhering the baselayer to the top of a subject's nose via the skin-contact adhesive onthe first major surface of the base layer; coupling a first end of thefirst major surface of the coupling layer to the second major surface ofthe base layer; and securing the leg of the coupling layer to thenasogastric tube.
 18. The method of claim 17, wherein securing the legof the coupling layer to the nasogastric tube includes wrapping the legabout at least a portion of a circumference of the nasogastric tube. 19.The method of claim 17, further comprising repositioning at least aportion of the first end of the coupling layer on the base layer.
 20. Atube securement system comprising: a base layer having a first majorsurface comprising an adhesive and a second major surface opposite thefirst major surface; and a coupling layer comprising a first endrepositionably coupled to the second major surface of the base layer,and a first leg connected to and extending from the first end of thecoupling layer and is disconnected from the second major surface of thebase layer, wherein the leg comprises a securement mechanism; and asecond leg extending outwardly from the first leg at an acute angle withrespect to the longitudinal direction of the first leg.
 21. Thesecurement system of claim 20, wherein the securement mechanismcomprises an adhesive.